Volume 26, Number 8—August 2020
Plasma-Derived Extracellular Vesicles as Potential Biomarkers in Heart Transplant Patient with Chronic Chagas Disease
|Date||Infection||Observation, treatment, outcome|
|2015 Aug||Cytomegalovirus, detected by serology||Diagnosed only by positive IgG serology, no active infection (no positive IgM serology). No treatment.|
|2015 Aug||Toxoplasmosis, detected by serology||Diagnosed only by positive IgG serology, no active infection (no positive IgM serology). No treatment.|
|2015 Nov||Heart transplantation on Nov. 28. Patient started with immunosuppressive therapy (tacrolimus, azathioprine, prednisone) until the end of follow-up.|
|2016 Jan||Chagas disease reactivation, detection by qPCR||Pretreatment sample collected on Jan 28. Patient started BZN treatment (2.5 mg/kg, twice a day, 60 d) on Feb 3.|
|2016 Mar||Bronchopulmonary aspergillosis, detected by serology and CT||BZN course interrupted on Mar 21. Completed 80% of the prescribed treatment.|
|2016 Mar||Bronchopulmonary aspergillosis||Aspergillosis treatment started on Mar 22. Initially with voriconazole and amphotericin B liposomal. Treatment was changed to posaconazole until the end of the follow-up.†|
|2016 Apr||Chagas disease reactivation, detected by qPCR||On Apr 14, patient started second round of BZN treatment until May 5, completing 100% of the prescribed treatment.|
|2016 May||Posttreatment sample collected on May 11.|
|2016 Aug||Late organ rejection. Patient died.|
*BZN, benznidazole; CT, computed tomographic scan; qPCR, quantitative PCR.
†Parasite clearance could be related to the prolonged used of posaconazole, as previously reported (6), and/or the combined use of posaconazole and benznidazole because a second round of the latter was started in April 2016.
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1Current affiliation: CIBER Epidemiología y Salud Pública (CIBERESP); Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.